Nakauchi Y, Suehiro T, Tahara K, Kumon Y, Yasuoka N, Ohashi Y, Kawada M, Hashimoto K
Second Department of Internal Medicine, Kochi Medical School, Japan.
Clin Exp Rheumatol. 1995 Sep-Oct;13(5):645-8.
A 45-year-old woman who had been diagnosed as having systemic lupus erythematosus (SLE) at the age of 28 years and who had been in remission developed severe urinary frequency, watery diarrhea, vomiting and weight loss. She also developed acute renal failure and her serological examination was consistent with active SLE. She had a markedly decreased urinary bladder capacity of 20 ml with hydroureteronephrosis. Histopathological study of her urinary bladder biopsy specimen showed mucosal edema, infiltration by lymphocytes and granulocytes, and deposition of IgA in the epithelium and submucosal region. We diagnosed this as a case of lupus cystitis. The patient's symptoms were alleviated by bilateral nephrostomy and corticosteroid therapy. In the present episode the patient showed none of the usual symptoms of SLE. This case and others reported in the literature show that lupus cystitis presents with specific signs and symptoms and therefore, this syndrome may represent a specific clinical manifestation of SLE.
一名45岁女性，28岁时被诊断为系统性红斑狼疮（SLE），病情曾一度缓解，现出现严重尿频、水样腹泻、呕吐及体重减轻。她还发展为急性肾衰竭，血清学检查结果与活动性SLE相符。她的膀胱容量显著减少至20毫升，伴有肾盂积水。对其膀胱活检标本进行组织病理学研究显示，黏膜水肿、淋巴细胞和粒细胞浸润，以及上皮和黏膜下区域有IgA沉积。我们将此诊断为狼疮性膀胱炎。通过双侧肾造口术和皮质类固醇治疗，患者症状得到缓解。在本次发作中，患者未出现SLE的常见症状。该病例及文献中报道的其他病例表明，狼疮性膀胱炎具有特定的体征和症状，因此，该综合征可能代表SLE的一种特定临床表现。
